Key TakeawaysA new report found mental health diagnosis disparities in the U.S.Asian patients, in particular, were much less likely to receive a diagnosis for depression or anxiety compared to White patients.Experts say these trends highlight barriers to care for people of color.
Key Takeaways
A new report found mental health diagnosis disparities in the U.S.Asian patients, in particular, were much less likely to receive a diagnosis for depression or anxiety compared to White patients.Experts say these trends highlight barriers to care for people of color.
Being diagnosed with anxiety or depression during a primary care visit may not only depend on your mental health status. A new analysis finds that there are large disparities in receiving a mental health diagnosis across races and ethnicities in the U.S.
An Athenahealth analysis of patient visits to primary care providers (PCPs) in 2020 found that although anxiety and depression are “strikingly common” in more than 24 million patients, the diagnosis of the conditions varied greatly between demographic groups.
Many experts say this data points to underlying disparities in mental health care in the U.S. After all, a patient is diagnosed with a disorder when they feel comfortable, or are able to, express their mental health symptoms with a PCP.
Overall, White patients were most likely to discuss their mental health with PCPs, and therefore receive a diagnosis if necessary, than those of all other racial groups. The gap for Asian patients was particularly wide—they were 227% and 213% less likely to be diagnosed with anxiety or depression, respectively, than White people.
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“We cannot look at racial disparities without recognizing that the systems in our country were built to serve the white majority, and the healthcare system is no exception,” Kelly Yang, BS, a medical student and research scholar at Albert Einstein College of Medicine in New York City, tells Verywell. She adds that factors like stigma and lack of Black, Indigenous, and people of color (BIPOC) healthcare professionals perpetuate these inequities.
How Race and Ethnicity Impact Your Health Care
The Athenahealth study tracked more than 24 million people over an 8-month period—between May and December of last year. Patients were considered to have anxiety or depression if at least one PCP visit led to a diagnosis. Demographic trends in diagnosis of depression and anxiety disorders included:
But the trends in race and ethnicity highlight barriers to care. In the study, White patients were significantly more likely to be diagnosed with either depression or anxiety than Black, Hispanic/Latino, and especially Asian patients.
Compared to Asian people, in particular, 7.2% and 4.7% of White patients were diagnosed with anxiety and depression, respectively. In comparison, Asian patients were only diagnosed at rates of 2.2% and 1.5%.
Disparities in Asian Mental Health Care
When considering these rates, some might assume Asian patients just don’t struggle as much with depression and anxiety. But that is far from reality, Yang says.
In a 2019 study, Yang and colleagues found that although Asian and White people might perceive their need for mental health care at different rates, that does not explain the wide gap in who actually gets diagnosed and treated.Specifically:
Why are rates for Asian respondents consistently lower? Asian respondents cited “not knowing where to go” as a barrier for treatment as a barrier more frequently than did White individuals.
One Provider’s Experience
Timothy Lo, LCSW, a psychotherapist in Chicago, says the Athenahealth report helps contextualize long-term problems. “The question is are Asian-Americans being diagnosed at a higher or lower rate based on them, or based on the system that they’re part of?”
Lo says the answer is the latter. Yang’s study, he adds, contextualizes the issues even further. “Part of it is simply utilization, that Asian-Americans are less likely to seek help despite knowing that it’s there, despite needing it.”
In general, this aligns with his anecdotal experience as a clinician. “In Asian populations, like most immigrant populations in the U.S., there is a greater stigma around accessing mental health services,” he says. Among his Asian clients, he sees a lack of acknowledgment around the topic of mental health, particularly among immigrants who did not grow up in the U.S.
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There can also be a language barrier, considering a minority of therapists speak Cantonese or Mandarin. “That has shown up for me multiple times, where folks have reached out to me because they’re desperately trying to find a therapist for themselves or family members who actually want to utilize services, but their English isn’t good enough,” he says. “I can’t speak [their language] nearly well enough to do clinical work.”
And in general, of the Asian clients he does see, they tend to seek him out through insurance. People who don’t have or can’t afford insurance can’t find help this way.
What This Means For YouIf you or someone you know is dealing with mental health issues and isn’t sure where to go for help, there are many directories that specifically list therapists from different backgrounds. For example, there’s the Asian, Pacific Islander, and South Asian American (APISAA) Therapist Directory,Latinx Therapydirectory,Therapy for Queer People of Colordirectory, and theSociety of American Indian Psychologists.
What This Means For You
If you or someone you know is dealing with mental health issues and isn’t sure where to go for help, there are many directories that specifically list therapists from different backgrounds. For example, there’s the Asian, Pacific Islander, and South Asian American (APISAA) Therapist Directory,Latinx Therapydirectory,Therapy for Queer People of Colordirectory, and theSociety of American Indian Psychologists.
How to Address These Disparities
Mental health care in the U.S. has been and is unaccommodating of cultural or language differences, Yang says, because the majority of the mental health workforce is made up of White individuals.
But that doesn’t mean it can’t change. “The healthcare field is moving in the right direction in that cultural competence is now heavily emphasized, more individuals of racial/ethnic minority backgrounds are entering the mental health workforce, and efforts such as theAll of Us projectare underway to include more diverse samples of participants in research studies,” Yang says. “However, we still have a long way to go before any form of equity can be reached.”
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When thinking about what needs to change to reduce disparities, Lo says it starts with access. Every single person who needs access to care should get it, removing all barriers including lack of multicultural providers, cost, scheduling, and location. “It would involve an enormous change in multiple ways across the entire mental health field,” he says. It would also involve universal health care, he adds.
5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Athenahealth.Athenahealth’s data analysis shows demographic inequalities in mental health diagnoses.Athenahealth.Data show inequalities in mental health diagnoses.Czeisler MÉ, Lane RI, Petrosky E, et al.Mental health, substance use, and suicidal ideation during the COVID-19 pandemic—United States, June 24–30, 2020.MMWR Morb Mortal Wkly Rep. 2020;69(32):1049-1057. doi:10.15585/mmwr.mm6932a1World Health Organization.Gender and women’s mental health.Yang KG, Rodgers CRR, Lee E, Lê Cook B.Disparities in mental health care utilization and perceived need among Asian Americans: 2012–2016.Psychiatr Serv. 2020 Jan 1;71(1):21-27. doi:10.1176/appi.ps.201900126
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Athenahealth.Athenahealth’s data analysis shows demographic inequalities in mental health diagnoses.Athenahealth.Data show inequalities in mental health diagnoses.Czeisler MÉ, Lane RI, Petrosky E, et al.Mental health, substance use, and suicidal ideation during the COVID-19 pandemic—United States, June 24–30, 2020.MMWR Morb Mortal Wkly Rep. 2020;69(32):1049-1057. doi:10.15585/mmwr.mm6932a1World Health Organization.Gender and women’s mental health.Yang KG, Rodgers CRR, Lee E, Lê Cook B.Disparities in mental health care utilization and perceived need among Asian Americans: 2012–2016.Psychiatr Serv. 2020 Jan 1;71(1):21-27. doi:10.1176/appi.ps.201900126
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Athenahealth.Athenahealth’s data analysis shows demographic inequalities in mental health diagnoses.Athenahealth.Data show inequalities in mental health diagnoses.Czeisler MÉ, Lane RI, Petrosky E, et al.Mental health, substance use, and suicidal ideation during the COVID-19 pandemic—United States, June 24–30, 2020.MMWR Morb Mortal Wkly Rep. 2020;69(32):1049-1057. doi:10.15585/mmwr.mm6932a1World Health Organization.Gender and women’s mental health.Yang KG, Rodgers CRR, Lee E, Lê Cook B.Disparities in mental health care utilization and perceived need among Asian Americans: 2012–2016.Psychiatr Serv. 2020 Jan 1;71(1):21-27. doi:10.1176/appi.ps.201900126
Athenahealth.Athenahealth’s data analysis shows demographic inequalities in mental health diagnoses.
Athenahealth.Data show inequalities in mental health diagnoses.
Czeisler MÉ, Lane RI, Petrosky E, et al.Mental health, substance use, and suicidal ideation during the COVID-19 pandemic—United States, June 24–30, 2020.MMWR Morb Mortal Wkly Rep. 2020;69(32):1049-1057. doi:10.15585/mmwr.mm6932a1
World Health Organization.Gender and women’s mental health.
Yang KG, Rodgers CRR, Lee E, Lê Cook B.Disparities in mental health care utilization and perceived need among Asian Americans: 2012–2016.Psychiatr Serv. 2020 Jan 1;71(1):21-27. doi:10.1176/appi.ps.201900126
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